1. Field of the Invention
The present invention concerns therapeutic devices for manipulating the human spine, including devices for manipulating the spine in its lumbar, thoracic, and cervical regions.
2. Background of the Invention
It is known to manipulate the human spine for therapeutic purposes by use of machines. The human spine and spinal muscles may be either active or passive during the course of machine manipulations.
Such manipulation may be on a large scale where extensive regions of the spine are bent, stretched, or otherwise subjected to external forces and pressures. The manipulations may alternatively be on a small scale wherein localized forces are applied to small areas of the spine, such as to a single vertebrae. Small scale manipulations of the human spine provide therapy for spinal dysfunction, spinal pain, or to exercise the spine and improve its performance. Equipment for performing localized spinal therapy is typically found in hospitals, doctor's offices, and reconstructive therapy centers.
Several requirements are common to many forms of spinal manipulation. Most of these requirements are met by a human spinal therapist who uses his or her hands and muscles to manipulate the patient's spine while using his or her sense of hearing, sight and touch to assess feedback from the patient regarding the effects of the manipulations.
It is more difficult to meet the requirements of spinal manipulation with a machine. It would be useful to do so, however, in order to reduce the costly human services of a physical therapist. Manipulation of the spine with a machine is also desirable due to the often high and prolonged forces applied to the patient that can cause fatigue in a human therapist.
A machine for manipulating the spine should always manipulate a patient's spine with consideration for the patient's therapeutic requirements and physical comfort. The patient should receive only those particular manipulations that the patient requires and the manipulations should never induce or aggravate an injury and should not be painful.
Accordingly, a machine for manipulating the human spine would preferably be versatile in the nature of the manipulations performed and fully adjustable during the performance of these manipulations. The functional flexibility of the machine is important so that the machine may perform the particular spinal manipulations that are individually required by a particular patient. The adjustability of the machine is important during the therapy of spinal dysfunction wherein ongoing machine manipulations may induce pain or injury to the patient. Upon any such adverse occurrences it is necessary that the patient, especially one who is substantially immobile relative to the machine, should be in complete control of the machine, and should be able to halt or otherwise control the manipulations.
A machine for manipulating the spine should also preferably be able to target specific spinal locations where manipulations are to be performed. At each targeted location, it is preferable that the size of the spinal area manipulated by the machine be adjustable. The location, pattern, amplitude, and amount of force applied within each area should also be adjustable. For example, a preferred location and pattern of force application by a human physical therapist can be examined to help define the requirements for machine manipulation. A physical therapist commonly manipulates localized regions of a patient's back proximate to selected spinal vertebrae, such as regions adjacent the lumbar, thoracic, or cervical vertebrae. The physical therapist commonly applies treatment to one or more areas which are each roughly the size of the therapist's fingertips. One common pattern of therapeutic manipulation used by a physical therapist is implemented by placing one finger upon each side of a spinal vertebrae and pressing. The amplitude and degree of force applied is determined by the muscular exertions of the therapist. The therapist uses his or her judgment and sensations of displacement and pressure to determine how much amplitude and pressure to apply and to know whether, and how, to continue with the spinal manipulations.
A machine for manipulating the human spine should be further adjustably controllable in the frequency and angles at which the spinal manipulations are performed. The typical manipulations by a human physical therapist may again be examined. It is common for the therapist to engage in a cyclical thrusting, or pressing, motion against, or proximate to, one or more spinal vertebrae. The motion is typically reciprocal, involving a thrusting application of pressure to the spine and a subsequent relief of this pressure. The thrusting motion is typically conducted for many dozens or hundreds of cycles at rates ranging to several cycles per minute. The thrusting motion is preferably done within a range of predetermined angles. These angles are typically chosen by the therapist in consideration of the particular spinal region is being manipulated. The angle and frequency of the thrusting manipulations are both controlled by the therapist.
A machine for manipulating of the spine would advantageously provide simultaneous coordinated manipulations at more than one spinal location. Simultaneous manipulations at multiple spinal locations desirably permit the spinal region between the manipulated locations to be beneficially affected. For example, if a thrusting motion is made against a few spinal vertebrae at each of two locations that are separated by several intervening spinal vertebrae, then a bending of the spine will be induced. This bending affects the intervening spinal vertebrae. This ability to bend or stretch a length of spinal vertebrae may be as therapeutic as the application of thrusting stimulation directly to such vertebrae.
A machine for manipulating of the spine would preferably be constructed to administer well established therapeutic and exercise regimens. The machine would desirably manipulate the spine only in manners that simulate spinal manipulations produced by a trained physical therapist. A trained spine manipulator would desirably be able to easily and directly control the machine, and also be able to instruct a patient to use the machine in a manner that duplicates manual therapeutic manipulation of the spine.
Machine simulation of all the variable and mechanically sophisticated parameters that characterize manual manipulation of the spine by a trained therapist thus becomes a task of considerable complexity.